Digoxin/Selected Antacids; Kaolin; Sucralfate Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not absorb digoxin properly.Some vitamins may contain "hidden" antacids such as some forms of magnesium.

What might happen:

Your blood levels of digoxin may decrease. This may decrease the beneficial effects of your digoxin.

What you should do about this interaction:

If you experience shortness of breath or a fast heartbeat, contact your doctor. It may be necessary to change the time you take each medicine or change you to a different medicine.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Giesing DH, Lanman RC, Dimmitt DC, Runser DJ. Lack of effect of sucralfate on digoxin pharmacokinetics. Gastroenterology 1983 May;84(5 Part 2):1165.
  • 2.Rey AM, Gums JG. Altered absorption of digoxin, sustained-release quinidine, and warfarin with sucralfate administration. DICP 1991 Jul-Aug; 25(7-8):745-6.
  • 3.Brown DD, Juhl RP. Decreased bioavailability of digoxin due to antacids and kaolin-pectin. N Engl J Med 1976 Nov 4;295(19):1034-7.
  • 4.McElnay JC, Harron DW, D'Arcy PF, Eagle MR. Interaction of digoxin with antacid constituents. Br Med J 1978 Jun 10;1(6126):1554.
  • 5.Allen MD, Greenblatt DJ, Harmatz JS, Smith TW. Effect of magnesium--aluminum hydroxide and kaolin--pectin on absorption of digoxin from tablets and capsules. J Clin Pharmacol 1981 Jan;21(1):26-30.
  • 6.Albert KS, Ayres JW, DiSanto AR, Weidler DJ, Sakmar E, Hallmark MR, Stoll RG, DeSante KA, Wagner JG. Influence of kaolin--pectin suspension on digoxin bioavailability. J Pharm Sci 1978 Nov;67(11):1582-6.
  • 7.Albert KS, Elliot WJ, Abbott RD, Gilbertson TJ, Data JL. Influence of kaolin-pectin suspension on steady-state plasma digoxin levels. J Clin Pharmacol 1981 Oct;21(10):449-55.
  • 8.Lanoxin (digoxin) Tablets US prescribing information. Covis Pharmaceuticals, Inc. August, 2018.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.